NUR 2633: Maternal Child Health Final Work Sheet
1. Dysmenorrhea – a common complaint with women – what are the non-pharmacological
and pharmacological treatments. NSAID’s (Motrin, Naproxen, Alive), heating pad, rest,
increase calcium, increase fluids, decrease red meat, alcohol, smoking drugs, exercise.
2. Obstetrical issues – pregnancy risks - Know Naegle’s Rule – to establish gestational age
ovulation occurs in the middle of the cycle, stress can affect cycle, as well as high
exercise, pregnancy, medications, drugs, hormones, obesity. Add 1 year, subtract 3
months, add 7 days. Pregnancy risks smoking, alcohol drinking, obesity, diabetes, drug
use, hypertension, poor nutrition, eating disorders ALL affect pregnancy. EDD can also
be measured by fundal height (Ex. Fundal height is measuring at umbilicus = 20 weeks)
3. Fetal assessment 3 things baby is okay – fetal heart tones (audible at 10-12 weeks),
movement (16-18 weeks for multiparis, 18-20 for prima gravida), fundal height (12-14
weeks, at the symphysis pubis, umbilicus is 20 weeks)
4. Poor nutrition, drugs, HTN, DM are all issues of placental perfusion – what will the fetal
result be – IUGR is the result, how do we identify IUGR? Smaller fundus. Uncontrolled
diabetes = large baby, larger fundal height, baby can have hypoglycemia after birth, birth
injuries and respiratory immaturity
5. Does the placenta provide nutrition? – no it provides for gas exchange, baby gets oxygen.
6. Anemia becomes a problem in pregnancy – can you discuss the maternal and fetal risks –
low hemoglobin = low oxygen, baby with low oxygen means less movement. Iron
ingestion can cause GI upset, tarry stools, constipation (increase fluids, fiber, stool
softeners and exercise)
7. Hyperemesis – excessive vomiting that exceeds more than 3 months, at risk for fluid and
electrolyte imbalance, manage by IV fluids and antiemetics (Zofran), small frequent
meals, avoid trigger foods, carb snack
8. Hypertension – preeclampsia has specific symptoms – please know these as well as
treatment modalities and nursing interventions – keep in mind Magnesium Sulfate
, nursing interventions – headaches, blurry vision, epigastric pain, bloated, edema, high
BP, protein in the urine. Manage by bed rest, dim the lights, Mag sulfate 4g maintenance
over 20-30 minutes’ bolus, maintenance 2g. Seizure precautions, and monitor baby, left
side lying. For Mag watch for mag toxicity and respiratory depression, check for urine
output, and deep tendon reflexes, vitals every hour. Lungs if have to deliver baby, use
Betamethasone to help with lung maturity. No bolus fluids in preeclampsia.
9. Pre- term labor – define it; signs and symptoms, treatment modalities and nursing
interventions – pelvic pressure, cramping, contractions, baby drop, lower back pain,
increase urine output and vaginal discharge. Can be caused by dehydration or infection.
Put on monitor, GIVE FLUIDS (Bolus Lactated ringers), FFN test before vaginal exam,
LABOR IS NOT LABOR WITHOUT CERVICAL CHANGE. 2CM OR 80% effaced,
start aggressively managing pre term labor with terbutaline (Causes maternal tachycardia,
watch heart rate), if unsuccessful go to mag sulfate and use betamethasone.
10. Diabetes Mellitus – Type 1, Type 2 and Gestational DM all have issues that are common
to all and specific to each. Note the concerns specific to each, management and fetal
surveillance a– atype a1 aconcerned awith acardiac, askeletal aand aCNS ain ababy, awoman
st
arequires aless ainsulin a1 atrimester abecause aof abasal ametabolic arate ais aincreased, athen
nd
aneeds aprogress aover a2 /3rd atrimester. aMonitor aclosely, ababies aat arisk afor asudden
afetal ademise, ahave amom amonitor a# aof afetal amovements. aType a2 aconcerned awith
acontrolling asugars, acontrol aby adiet,
and ahypoglycemic/macrosomic ababy. aGestational aDM, asame ainterventions aas atype a2
aDM.
11. Define aMacrosomia a– aand awhat aare athe arisks a– alarge ababy, alarger afundal aheight,
ababy acan
have ahypoglycemia aafter abirth, abirth ainjuries aand arespiratory aimmaturity
12. What ais aan aNST, aand aa aBPP afor awhom awould ayou arecommend athese atests? a– aNon
astress atest, ato aensure afetal awell abeing, aif anon areactive amove ato aBPP, aif aBPP ascores
afrom a6-8 akeep amonitoring, aif aless athat a6 astart ato athink aabout adelivering, ahostile
, auterine aenvironment.
1. Dysmenorrhea – a common complaint with women – what are the non-pharmacological
and pharmacological treatments. NSAID’s (Motrin, Naproxen, Alive), heating pad, rest,
increase calcium, increase fluids, decrease red meat, alcohol, smoking drugs, exercise.
2. Obstetrical issues – pregnancy risks - Know Naegle’s Rule – to establish gestational age
ovulation occurs in the middle of the cycle, stress can affect cycle, as well as high
exercise, pregnancy, medications, drugs, hormones, obesity. Add 1 year, subtract 3
months, add 7 days. Pregnancy risks smoking, alcohol drinking, obesity, diabetes, drug
use, hypertension, poor nutrition, eating disorders ALL affect pregnancy. EDD can also
be measured by fundal height (Ex. Fundal height is measuring at umbilicus = 20 weeks)
3. Fetal assessment 3 things baby is okay – fetal heart tones (audible at 10-12 weeks),
movement (16-18 weeks for multiparis, 18-20 for prima gravida), fundal height (12-14
weeks, at the symphysis pubis, umbilicus is 20 weeks)
4. Poor nutrition, drugs, HTN, DM are all issues of placental perfusion – what will the fetal
result be – IUGR is the result, how do we identify IUGR? Smaller fundus. Uncontrolled
diabetes = large baby, larger fundal height, baby can have hypoglycemia after birth, birth
injuries and respiratory immaturity
5. Does the placenta provide nutrition? – no it provides for gas exchange, baby gets oxygen.
6. Anemia becomes a problem in pregnancy – can you discuss the maternal and fetal risks –
low hemoglobin = low oxygen, baby with low oxygen means less movement. Iron
ingestion can cause GI upset, tarry stools, constipation (increase fluids, fiber, stool
softeners and exercise)
7. Hyperemesis – excessive vomiting that exceeds more than 3 months, at risk for fluid and
electrolyte imbalance, manage by IV fluids and antiemetics (Zofran), small frequent
meals, avoid trigger foods, carb snack
8. Hypertension – preeclampsia has specific symptoms – please know these as well as
treatment modalities and nursing interventions – keep in mind Magnesium Sulfate
, nursing interventions – headaches, blurry vision, epigastric pain, bloated, edema, high
BP, protein in the urine. Manage by bed rest, dim the lights, Mag sulfate 4g maintenance
over 20-30 minutes’ bolus, maintenance 2g. Seizure precautions, and monitor baby, left
side lying. For Mag watch for mag toxicity and respiratory depression, check for urine
output, and deep tendon reflexes, vitals every hour. Lungs if have to deliver baby, use
Betamethasone to help with lung maturity. No bolus fluids in preeclampsia.
9. Pre- term labor – define it; signs and symptoms, treatment modalities and nursing
interventions – pelvic pressure, cramping, contractions, baby drop, lower back pain,
increase urine output and vaginal discharge. Can be caused by dehydration or infection.
Put on monitor, GIVE FLUIDS (Bolus Lactated ringers), FFN test before vaginal exam,
LABOR IS NOT LABOR WITHOUT CERVICAL CHANGE. 2CM OR 80% effaced,
start aggressively managing pre term labor with terbutaline (Causes maternal tachycardia,
watch heart rate), if unsuccessful go to mag sulfate and use betamethasone.
10. Diabetes Mellitus – Type 1, Type 2 and Gestational DM all have issues that are common
to all and specific to each. Note the concerns specific to each, management and fetal
surveillance a– atype a1 aconcerned awith acardiac, askeletal aand aCNS ain ababy, awoman
st
arequires aless ainsulin a1 atrimester abecause aof abasal ametabolic arate ais aincreased, athen
nd
aneeds aprogress aover a2 /3rd atrimester. aMonitor aclosely, ababies aat arisk afor asudden
afetal ademise, ahave amom amonitor a# aof afetal amovements. aType a2 aconcerned awith
acontrolling asugars, acontrol aby adiet,
and ahypoglycemic/macrosomic ababy. aGestational aDM, asame ainterventions aas atype a2
aDM.
11. Define aMacrosomia a– aand awhat aare athe arisks a– alarge ababy, alarger afundal aheight,
ababy acan
have ahypoglycemia aafter abirth, abirth ainjuries aand arespiratory aimmaturity
12. What ais aan aNST, aand aa aBPP afor awhom awould ayou arecommend athese atests? a– aNon
astress atest, ato aensure afetal awell abeing, aif anon areactive amove ato aBPP, aif aBPP ascores
afrom a6-8 akeep amonitoring, aif aless athat a6 astart ato athink aabout adelivering, ahostile
, auterine aenvironment.
